House Finance takes up abortion funding

Sen. John Coghill, R-Fairbanks, and Rep. Gabrielle LeDoux, R-Anchorage, speaks to the House Finance Committee about Sponsor Substitute for Senate Bill 49 at the Capitol on Tuesday. The act relates to women's health services and defining 'medically necessary abortion' for the purposes of making payments under the state Medicaid program.

Michael Pauley, of Alaska Family Action, testifies in favor of Sponsor Substitute for Senate Bill 49 in front of the House Finance Committee at the Capitol on Tuesday. The act relates to women's health services and defining 'medically necessary abortion' for the purposes of making payments under the state Medicaid program.

Pediatrician Dr. George W. Brown testifies against Sponsor Substitute for Senate Bill 49 in front of the House Finance Committee at the Capitol on Tuesday. The act relates to women's health services and defining 'medically necessary abortion' for the purposes of making payments under the state Medicaid program.

Laura Powers testifies with her daughters, Izabella, left, and Korbyn, right, against the Sponsor Substitute for Senate Bill 49 in front of the House Finance Committee at the Capitol on Tuesday. The act relates to women's health services and defining 'medically necessary abortion' for the purposes of making payments under the state Medicaid program.

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JUNEAU — The House Finance Committee voted Tuesday to remove language from an abortion funding bill that called for the state to provide expanded women’s health and family planning services.

The language had been added to SB49 on the Senate floor last year and offered by Sen. Berta Gardner, D-Anchorage.

The bill seeks to further define what constitutes a medically necessary abortion for the purposes of Medicaid payments. It went before the committee Tuesday with a companion House bill, HB173. The committee heard about 3 1/2 hours of testimony over two meetings but kept the bill for further consideration.

Senate Majority Leader John Coghill, R-North Pole, the sponsor of SB49, said he objected to the amendment regarding the health program, calling it a mandate beyond services the state already provides.

The committee voted 8-3 to adopt a version of the bill without the language. Voting against were Reps. Les Gara, D-Anchorage, David Guttenberg, D-Fairbanks, and Lindsey Holmes, R-Anchorage.

The Alaska Supreme Court has held that the state must fund medically necessary abortions if it pays for other procedures deemed medically necessary for people in need. Coghill has said he is trying to bring clarity to what “medically necessary” means.

He said Tuesday that he understands a woman’s right to choose an abortion. But he said that right “doesn’t necessarily have to fall on somebody else to pay for.”

The bills call on the Department of Health and Social Services to fund no abortion services under Medicaid unless the abortions are medically necessary or the pregnancy was the result of rape or incest.

The measures would define medically necessary abortions as those needed to avoid a threat of serious risk to a woman’s life or physical health. That could mean a serious risk of death or “impairment of a major bodily function” due to conditions including epilepsy, congestive heart failure, coma, renal disease that requires dialysis, or 17 other conditions.

The bills also include what has been called a “catch-all” option: “another physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy that places the woman in danger of death or major bodily impairment if an abortion is not performed.”

Language in the bills tracks closely with regulations that were approved after being proposed during the interim by state Health Commissioner Bill Streur. The regulations are now the subject of a court challenge brought by Planned Parenthood of the Great Northwest. A judge has barred enforcement of those regulations, pending trial.

The regulations also define an abortion as medically necessary if the mother has a psychiatric disorder that places her in “imminent danger of medical impairment of a major bodily function” if an abortion is not performed. That provision is not included in the bills. Coghill said medical testimony on the Senate side convinced him that psychological conditions “were not a threat to the health of the mother, based on pregnancy.”

Much of the public testimony before the committee Tuesday morning was in opposition to the bills. Joshua Decker, interim executive director of the American Civil Liberties Union of Alaska, said the bills raised constitutional questions. Others called it a government intrusion and a waste of time, given the court challenge. Several spoke in support of expanded family planning services.

Currently, childless adults do not qualify for Medicaid. But about 14,000 additional Alaskans could be eligible for reproductive health and family planning services if they were expanded as proposed by the amendment, Streur said. The annual cost for accessing family planning services has been estimated at roughly $800 per person.

Streur told reporters he would have to think an expanded program would help to reduce unwanted pregnancies and abortions but said he didn’t know to what degree that might happen.

Gardner, in an interview, said if the goal is to reduce abortions, the state needs to make sure people have access to effective birth control measures.

Rep. Gabrielle LeDoux, R-Anchorage, who’s sponsoring the House bill, said she didn’t see it as a “pro-life” or “pro-choice” bill but rather as a fiscal bill. She said if the committee wanted to expand the program it could look at doing that as part of the ongoing budget talks. But she said she didn’t see how that discussion fit in with what the bills were trying to accomplish.

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